Mike Magee In this week’s The New Yorker, David Remnick reflects on “Trump’s illiberalism” and its’ test of the resilience of “sturdy-seeming American values” and the endurance of “institutions that the President has scorned and threatened.” He sees active turnout in the 2018 midterm elections as part of the test, but also suggests that any […]
Struggling to break free from Obamacare oppression, Idaho is offering low-cost health plans that achieve this goal by avoiding covering anyone who’s been sick in the past and skimping on coverage for any diseases that might make you sick in the future. These strategies are, inconveniently, explicitly banned by the Affordable Care Act.
Fortunately, I have a solution perfect for Idaho and other GOPers eager to emulate Idaho’s example. My plan covers young and old, sick and healthy, fitness buff and couch potato, all for the same incredibly low price. No one, and no illness, is excluded.
Welcome to the Placebo HMO, dedicated to serving every American who fervently believes you don’t need real health insurance.
We’re a faith-based plan that offers empathetic, sincere and personalized advice from a broad range of highly skilled actors pretending to be doctors. Whether it’s a “seen everything” veteran like Tom Hanks or Meryl Streep in The Post or a bright-eyed idealist like Emma Stone and Ryan Gosling in La La Land, we provide unparalleled freedom of provider choice that plans dependent on actual doctors cannot match.
At Placebo HMO, we’re committed to consumerism. Your beliefs, whatever they may be, always come first, since we want you to have a doctor you can trust. So, for instance, you might choose our popular “Dr. Cooper” model, available not only in male and female versions (“Bob” or “Betty” Cooper) and a variety of ages, but also in a choice of religions (Protestant, Catholic or Mormon) and races (black or white). We also offer “Dr. Garcia,” “Dr. Gu,” “Dr. Gandhi” or “Dr. Greenberg.” Not all selections are available in all states; e.g., our Idaho plan, for example, does not include “Dr. Mohammed.”
You choose who to see (or avoid). Whatever your choice, you need never worry that your faith will be shaken by an upsetting political opinion. Each of our “doctors” has been specially trained to enthusiastically agree with whatever President Trump may have said that day.
The way our plan works is simple. If you feel ill, you don’t have to take off work or find a sitter for the kids while you trundle down to a crowded waiting room filled with God-knows-what contagious disease. Instead, just dial our toll-free number or FaceTime or Skype us, and you can talk directly to your “family doctor.” If you believe you need a “specialist,” no problem! Unlike real HMOs, we don’t require a burdensome referral.
Our “doctors” are not distracted by computerized medical records or calls from the hospital, so they can focus only on you — your symptoms, your concerns, your medical history, your life. For patients who believe their doctor should be a true partner, we offer shared decision-making: working together, our “doctor” and you can Google your symptoms.
Most of all, our doctors truly listen — unlike actual doctors, they won’t be interrupting you after 18 seconds to tell you what to do — and they truly care. To demonstrate their concern our “doctors” will gladly write you a prescription for a placebo drug. It will either be a brand name (which we’ll tell you ordinarily costs $150 a pill because of its powerful ingredients) or generic (which we’ll tell you ordinarily costs $1.50 a pill, but works just as well).
There are no co-pays, no deductibles and no paperwork. Best of all, our plan costs just two dollars a day — exactly the price of a daily Powerball lottery ticket. You gotta believe!
Can a placebo really help you? Of course it can. It’s been shown, for instance, that placebos can offer powerful pain relief — putting the Placebo HMO on the leading edge of solving our nation’s opioid crisis. No less an authority than the Harvard Health Letter concluded that “the placebo effect may be an integral part of good medical care,” which suggests that the Placebo HMO might have been named the Harvard HMO! (Just kidding, Harvard.)
In sum, the Placebo HMO provides everything that Obamacare opponents have been agitating for: Freedom of choice. Patient-centered consumerism. Respect for local preferences. Affordability rooted in the power of faith.
And, if you get really sick, we give you directions to the nearest hospital emergency room.
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Huge news hit today as Theranos, its Chairman and CEO Elizabeth Holmes and its former President and COO Ramesh “Sunny” Balwani were charged with “elaborate, years-long fraud” by the Securities and Exchange Commission. The litany of supposed violations of the Securities Act of 1933 and the Securities Exchange Act of 1934 are almost as dizzying as the detailed factual allegations of repeated, willful fraud perpetuated by Holmes and Balwani on investors who likely should have known better.
Reviewing the SEC complaint against Holmes, it’s stunning to see the extent to which Holmes and Balwani were able to pull the wool over investors’ eyes. The highlights of the SEC allegations include:
- In 2010, even knowing that Theranos’ miniLab product was not commercially ready, Holmes and Balwani pursued partnerships bringing the product to “Patient Service Centers” at a major pharmacy chain (Walgreens) and a national grocery chain (Safeway).
- Holmes directly told pharmacy executives that Theranos could conducts hundreds blood tests through a fingerstick in under an hour for a much lower cost than other competing project even though the technology had not been finalized.
- Holmes also told Walgreens that its analyzer was already deployed on military helicopters when no such relationship existed.
- In 2013, just prior to Theranos’ launch at Walgreens, Theranos realized its miniLab product would not be ready so it substituted an earlier production – one that could only be used to perform immunochemistries, for patient testing. They never told their partners about this issue, in fact denying any such issues, and instead used modified third-party technology.
- Even though Theranos failed to use its own technology, it presented itself to the media and investors as having achieved a technological breakthrough using its own proprietary technology.
- In late 2013, Theranos was struggling with only $30 million in cash and short-term securities – which it promised to burn through in a few months.
- In 2014, Holmes convinced the board to create a new, separate class of shares (“Class B Shares”) which had super-voting power and could only be given to Holmes. Thus, after a stock split and fundraising round, Holmes owned only just over half of the company’s shares but retained over 99 percent of its voting power.
- Between 2013 and 2015, Holmes, Balwani and Theranos raised over $700 million from two rounds of financing with investors relying on the false and misleading statements by Holmes, Balwani and Theranos.
- While courting investors, Holmes not only made false or misleading statements about Theranos’ technology and its usage of it but also about:
- Historical contracts with the U.S. Department of Defense to convince investors of their supposed track record of success.
- The relationship between Theranos and Walgreens and Safeway, which were presented as thriving when they were actually stalled.
- Whether or not Theranos required FDA approval of its technology.
- Theranos’ existing and projected revenues.
The breadth and scope of these lies is stunning. And such fraud would likely bring cries for criminal sanction in other fields, in the Valley, the overwhelming attitude to potential Department of Justice (DOJ) criminal charges accompanying SEC sanctions appears to be one of “who cares”.
In 2016, Thomas Lee, then of the San Francisco Chronicle actually accused federal prosecutors at the DOJ for “grandstanding” when they announced their criminal probe of Theranos’ practices, independent of the SEC.
His argument? That “[f]ederal prosecutors rarely investigate securities fraud at privately held startups, if ever” due to the high bar for putting someone behind bars and that the “supposed victims” should have known better. He distinguished between ordinary people and sophisticated venture capital firms that should have known better.
Some of what Lee says is true. White collar criminals rarely face criminal investigations and charges for defrauding corporate investors. Sympathy is hard to come by for VCs who fail to do the due diligence to see through an amateurish con pulled by a neophyte founder and a President and COO shrouded in mystery. And the DOJ does have limited resources in tackling such a complex and unusual case.
But crucially, Lee is wrong on who is hurt by Theranos’ actions and downfall. Not only were actual consumers defrauded by Theranos’ dubious tests but there is also likely to be downstream costs downloaded onto consumers by Walgreens and Safeway for their failed foray with Theranos.
And that’s the problem.
With healthcare costs running amuck, investments in shiny technology offered by charlatans represent a rapidly cumulating waste of resources and time and less money for other, worthier initiatives. Instead of focusing on how Theranos’ treatment deviates from the U.S. government’s traditional complacency on fraud, perhaps its time to recognize a special responsibility among those companies purporting to operate in the healthcare technology sector should act with a higher ethical standard.
Make no mistake. While Theranos was particularly brazen in its approach to massive fraud, the truth is that the current lax environment in terms of criminal sanctions may have allowed another Theranos to fester. Fraud costs society and when fraud affects funds earmarked for innovation in healthcare, it specifically hurts the sector. So maybe it’s time to throw the book at Theranos and those trading in fraudulent science – and make sure it hurts.
Jason Chung is the Law & Technology Editor at The Health Care Blog. He also writes on the intersection of health, technology and sports as the senior researcher and attorney at NYU Sports and Society, a think tank dedicated to the study of sports and social issues.
Things don’t look good for the Theranos leadership in terms of the SEC charges. The company already saw a three-year partnership with Walgreen’s collapse leaving many customers wondering if they had been deceived. The technology, which Holmes and her company touted as disruptive and revolutionary, never worked. So what happened to permit so much enthusiasm and money to be spent on a useless technology?
First, the company never published on its technology. The promise of small volume blood testing sounded great and indeed is great for many reasons not the least of which a lot less misery for patients who need to get a lot of painful blood drawn for tests. But no publication, no data driven presentations at professional society meetings, a lack of transparency turned Theranos into an 8 billion dollar Dutch tulip bubble.
Blathering on about disruption may sell well in Silicon Valley software start-ups and with the titans of change at angel investment firms but it does not fly in health care. Coming up with an app to order food delivery is not the same as proving you have a reliable tool for accurately testing blood or for that matter genes, brains or excretion. Medical devices need to work with amazing reliability and there are government regulatory hurdles appropriately in place to insure they do. A clever PowerPoint and a lot of buzzwords is not what innovation needs to be in health care.
Too much of a good thing is bad. Too much of a good thing that rests on hype, hand-waving and wishful thinking combined with greed is worthless. Let Theranos be a warning—pure disruption is not the best way to go in health care.
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